A multicentre double-blind randomised controlled trial evaluating the efficacy of daily use of antibacterial mouthwash against oropharyngeal gonorrhoea among men who have sex with men: the OMEGA (Oral Mouthwash use to Eradicate GonorrhoeA) study protocol

作者：Chow Eric P F^*; Walker Sandra; Hocking Jane S; Bradshaw Catriona S; Chen Marcus Y; Tabrizi Sepehr N; Howden Benjamin P; Law Matthew G; Maddaford Kate; Read Tim R H; Lewis David A; Whiley David M; Zhang Lei; Grulich Andrew E; Kaldor John M; Cornelisse Vincent J; Phillips Samuel; Donovan Basil; McNulty Anna M; Templeton David J; Roth Norman; Moore Richard; Fairley Christopher K

来源：BMC Infectious Diseases, 2017, 17(1): 456.

DOI：10.1186/s12879-017-2541-3

• Men who have sex with men
• Sexually transmitted infection
• Gonorrhoea
• Mouthwash
• Prevention
• Oropharyngeal
• Throat
• Topical antiseptics
• Prophylaxis

Background: Gonorrhoea is one of the most common sexually transmissible infections in men who have sex with men (MSM). Gonorrhoea rates have increased substantially in recent years. There is concern that increasing gonorrhoea prevalence will increase the likelihood of worsening antibiotic resistance in Neisseria gonorrhoeae. A recent randomised controlled trial (RCT) demonstrated that a single-dose of mouthwash has an inhibitory effect against oropharyngeal gonorrhoea. We are conducting the first RCT to evaluate whether daily use of mouthwash could reduce the risk of acquiring oropharyngeal gonorrhoea.
Methods/design: The OMEGA (Oral Mouthwash use to Eradicate GonorrhoeA) study is a double-blind RCT and will be conducted at several sexual health clinics and high caseload General Practice (GP) clinics in Melbourne and Sydney, Australia. A total of 504 MSM attending the participating sites will be recruited. Participants will be randomised to either using 'Study mouthwash A' or 'Study mouthwash B' for 12 weeks. Study mouthwash A was inhibitory against N. gonorrhoeae in vitro, whereas study mouthwash B was not. Participants will be instructed to rinse and gargle the study mouthwash for 60 seconds every day. The primary outcome is the proportion of participants with oropharyngeal gonorrhoea detected by nucleic acid amplification test by 12 weeks.
Discussion: The results from this trial may provide a novel way to reduce gonorrhoea prevalence and transmission without the use of antibiotics that may be associated with development of resistance. If shown to be effective, the widespread use of mouthwash will reduce the prevalence of oropharyngeal gonorrhoea, which plays key role in driving the emergence of gonococcal antimicrobial resistance through DNA exchange with oral commensal bacteria. The anticipated net effect will be interruption of onward transmission of N. gonorrhoeae within high density sexual networks within MSM populations.

• 出版日期2017-6-28